Avneet Johal | ‘mental illness closet’

Posted by christina.jung & filed under People to Watch.

Esther Frid holds "El Atardecer de la Vida," a book she wrote about the stories of seven senior Latin American women living in Canada

Photo credit: Rupali Lamba (rupalius2@gmail.com)

Avneet Johal is the Project Director for the upcoming Miles for Mental Health Run and Walk on May 7, 2011 at Queen’s Park in New Westminster. He spoke with Schema Magazine about the impact of mental health stigma on Canadians and the particular challenges young foreign-born Canadians face in coming out of the ‘mental health closet.’

Coming out of the mental illness closet:

Johal likens the Walk to the Vancouver Pride Parade, which he hopes will break the stigma around mental illness for first, 1.5, second and third generation Canadians, as the Parade did for many gay, lesbian, bisexual transgender individuals in Vancouver.

“The first Vancouver Pride walk had about 20 to 25 people marching in the streets. Now it is the city’s second-largest event.” Johal said. “Not too long ago, even in places like Vancouver, there was definite stigma surrounding homosexuality. Some people would say ‘it’s not biological, it’s a choice’.”

It’s a crutch, it’s an excuse.

He compares the experience of being “closeted” to the obstacles mentally ill people face in telling their families they have a disease. He points out that patients are forced to keep the illness to themselves “[just as LGBT individuals] had to keep their sexual orientations to themselves when it came to job offers and paperwork.”

This is a dangerous situation, particularly when looking at the high rates of mental illness in the young, working-age Canadian population.

Johal notes that the leading cause of hospitalization for people age 20 to 44 in Canada (i.e. the active population) is mental illness. He also notes suicide is the second leading cause of death for young people aged 16 to 24.

“We’ve known that for some time, and yet I haven’t personally seen much of a shift in education,” he said.

Stigma in immigrant communities

Johal’s message to young Canadians is rooted in the silence he has personally experienced around mental illness in the Indo-Canadian community. “The stigma is overwhelming across Canada, and I do think it is worse in immigrant populations.” he said.

Studies on mental health in immigration populations in Canada point to the existence of mental illness stigma in immigrant communities.

It’s not biological, it’s a choice.

A 2008 University of Calgary study of white, Chinese, South Asian and Southeast Asian populations living in Canada found that, overall, people from East Asian and South Asian communities in Canada are less likely to seek mental health care than white people, and Chinese people with depression are even less likely to access mental health services than their South and Southeast Asian counterparts.

In addition, Here to Help, a coalition of mental health and addictions non-profit agencies, states that immigrants may have lower reported incidents of mental health, but higher prejudice against it.

“Due to family-shared shame, and different cultural perceptions of mental illness and its causes, many members of minority groups delay treatment,” the Association states, citing Statistics Canada and government research on Canadian immigration and health.

Lost in translation: the generational gap in acceptance:

There is also evidence that older and first generation immigrants do not see eye to eye on the issue of mental illness with younger members of their communities.

“I don’t think second generation people of various backgrounds and nationalities have the same drive and work ethic that maybe their parents or the first generation had,” Johal said. “So with a new immigrant population, the idea that by working hard you can do anything, almost transposes itself onto the idea that by working hard you can overcome your mental illness. ‘Get over it, and keep moving on with your life’. Again: ‘it’s a crutch, it’s an excuse’.”

A Population Studies paper from the University of Western Ontario reports that new immigrants over the age of 15 across Canada report depression less than individuals who have been in the country at least 10 years. The gap closes with the length of time the immigrant has spent in Canada.

However, the McCreary Centre’s 2003 Adolescent Health Survey, shows that newly arrived immigrant youth in grades 7 to 12 report the same levels of mental distress as Canadian-born youth. What accounts for the discrepancy?

The answer is not clear. It could be that newly arrived immigrant youth struggle with different stressors while integrating into Canadian society than their older counterparts. Alternatively, it might be that the longer they live in Canada, there is less pressure to hide mental distress from their families.

It affects everybody…

Johal feels the gap in generational understanding of mental illness has much to do with media depictions that link it directly to violence and other negative stereotypes. In his opinion, immigrant parents receive news of their children’s mental distress or illness with such images in mind.

Not a ‘white’ disease

He also cautions against the racialization of psychological affliction as a ‘white person’s disease.’ He recounts a comedy event at which a Chinese comedienne with mental illness asked the audience what Chinese people thought of mental illness.

“Her response was: ‘It’s absolutely fine—not a problem—as long as white people have it.’ The audience laughed,” he said. “But that comment is steeped in fact.”

Johal said his professional colleagues in mental health community work frequently encounter people with such attitudes.

“A girl from China who works with us says it all the time: Chinese people don’t respond well to a member of ‘their community’ having a mental illness,” he said.

The Walk may help begin a more nuanced conversation between Canadians of all backgrounds about mental illness.

“It affects people of all backgrounds, and it doesn’t make a difference: rich, poor, educated, uneducated,” Johal said. “It affects everybody.”

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